Method and apparatus for treatment of scoliosis



Feb. 15, 1955 'H. L. WENGER 2,702,031

METHOD AND APPARATUS FOR TREATMENT OF SCOLIOSIS v FiledSept. 25, 1953INVENTOR.

.HLaSZe Wercgen United States. PatentO METHOD AND APPARATUS FORTREATMENT OF SCOLIOSIS I Herman Leslie Wenger, New York, N. Y.Application September 25, 1953, Serial No. 382,368

'2 Claims. (Cl. 128-78) Scoliosis is better known outside of the medicalprofession as curvature of the spine. At the present time the treatmentfor scoliosis is such that it is better to leave most of the mild casesuntreated. 1n bad cases, where treatment is necessary, such treatmentinvolves encasing the patient in a cast beginning at the head and neckand enclosing the body, but with the arms free, and extending down toone knee, leaving the other leg free. The patient is required to remainin this cast for a period averaging one year which requireshospitalization during the entire period. The cast is provided withhinges so that periodically it may be bent, after portions are cuttherefrom at the joining edges, and reinforced. During this processmechanical force is applied to force the spine of the patient morenearly straight so that the cast will hold the patient in the newposition. Later a window is cut in the plaster cast, exposing thepatients back for the purpose of performing bone surgery of the spine.This surgery consists of some type of bone fusion. In addition to beinglong and expensive, this treatment is extremely uncomfortable.

I have invented a new apparatus for, and method of, treating scoliosisinvolving a single operation, with no cast, and in which the patient mayleave the hospital in a few weeks with a permanent correction of thearea involved in the treatment. I will first describe my apparatus andthen the method of using it.

In the drawings:

Figure 1 is an outline of a human form to which my apparatus has beenapplied in acordance with my method;

Figure 2 is a cross-section of a portion of my apparatus;

Figure 3 is an elevation partly in section of my complete apparatus;

Figure 4 is a section along the lines 4--4 of Figure 3, looking in thedirection of the arrows; and

Figure 5 is a section along the lines 55, Figure 2, lookingin thedirection of the arrows.

Similar reference numerals refer to similar parts throughout thefigures.

My apparatus comprises a tubular sleeve 1 threaded on the outside forengagement with similar threads on the inside of a second tubular sleeve2. At the right end of the tubular sleeve 2, as seen in Figure 2, thereis a swivel connection to a forked projecting member 3. The swivelmember 3 has a head 4 which is fixed in the tube 2 so that the member 3cannot be pushed in or out but is allowed to rotate freely. The swivelmember 3 is U- shaped at its upper end (right end in Figure 2). Thisportion engages a screw 5 which is previously placed into the body ofthe vertebra. This U-shaped member 3 fits loosely around the shaft ofthe screw. Through holes 7 a wire 8 is twisted for the purpose ofpreventing this U- shaped member 3 from slipping out of position inmaintaining its apposition to the shaft of the screw. The screw isplaced into the body of the vertebra sufliciently to be firm and yet asutficient portion is left protruding so that the member 3 can engagethe shaft.

Just below head 4 of member 3 a disc 10 is placed within the sleeve 2.This disc is affixed to the shaft 2 by two steel pins 11. .In the centerof disc 10 is a square hole so designated as to receive shaft 12 whichserves as a key. When shaft 12 is inserted through the sleeve 1 thesquare end of the shaft fits into the square opening in disc 10. Whenthe shaft 12 is rotated it causes sleeve 2 to rotate around the swivelmember 3 and sleeve 1, which remain stationary.

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Sleeve 1 is fixed on a base 13 by pins 14. This has is attached tosleeve 1 so that the sleeve 1 remains stationary while the superimposedsleeve 2 rotates about the sleeve. The base 13 is so attached to sleeve1 that it can swivel, but prevents sleeve 1 from rotating. The base 13has three perforations 15 for screws to be inserted therethrough andinto the pelvic bone. These two screws fix the base 13 so that it cannotrotate, and also prevent the shaft 1 from rotating.

A long pin 12, which is square in cross-section, may be inserted withinthe sleeves 1 and 2. This long pin 12 when inserted through the sleeves1 and 2 fits into the square hole within disc 10. When shaft 12 isrotated, it will rotate sleeve 2 causing this sleeve either to rise orflazll depending upon the direction of the turning of shaft The long pin12, which serves as a key to fit into the square hole in disc 10, isrotated by means of a key 16 which fits on the end of pin 12. This canbe either a flanged key similar to a roller skating key, or anyapparatus which will rotate pin 12.

It will be apparent from the foregoing description that if sleeve 1 isheld in fixed position at the brim of the pelvis, while the pin 12 isinserted through sleeves 1 and 2 into the disc 10, a torque will beexerted upon sleeve 2. The sleeve 2 will rotate with respect to sleeve1, and the two sleeves will move together or apart depending upon thedirection of rotation.

In the treatment of scoliosis, I make an incision on the side of thepatient and drill a hole through the pelvic bone through which may beinserted the rod 12 of my apparatus. I also insert the screw 5 in thevertebra of the spine. I then place the base 13 against the pelvic bonein the position illustrated in Figure l, with the sleeves 1 and 2 inthreaded engagement, to be as short as necessary. The U-shaped member 3is then forced against the screw 5 by turning key 16 and sufficientpressure is exerted against the screw at the angle which it makes withthe vertebra to force the vertebra into the erect position. The wire 8is then inserted through the holes 7 to prevent member 3 from becomingdislodged from its point of force against the screw 5. After suificientforce is used to correct the curvature of the spine, screws are placedinto member 13 so that the flange is anchored firmly to the rim of thepelvis and the key 12 is withdrawn. The various layers of tissue arethen closed and the treatment is complete.

In severe curves the pin 12 can be left in position and at some laterdate further correction can be made before the key 12 is removed. Thisprocess can be repeated as often as necessary.

This treatment will, of course, be accompanied by the use of X-rays todetermine the position of the apparatus and correction of the curvatureof the spine.

In a severe case, I have found that the desired correction may becompleted within a week or ten days and the patient may be allowed toleave the hospital in a few weeks. All of the apparatus is left withinthe patients body when he leaves the hospital except the pin 12 and thekey 16. This apparatus may remain permanently in the patients body, ormay be removed therefrom in another operation after a year or two ifnecessary or desirable.

For many years metal has been inserted in human bodies by doctors fortreatment as, for example, the use of metal plates over the skull, orthe use of metal for improving the operation of joints or assisting inthe healing of fractures. My apparatus may be made of any material whichhas been found suitable for perma- My patented apparatus; is availableto any responsible manufacturer at a reasonable royalty, which royaltywill be set at a figure only sufficient to'cove'r my expenses ininsuring that the apparatus produced is of suitable quality for itspurpose What is claimed is:

1. A device for treating scoliosis comprising a first sleeve. threadedon the inside, a second sleeve threaded on the outside interengaging thethreads in the first sleeve, aflange on said second sleeve whereby saidsleeve may be held in fixed position, means on the device forrotationing said sleeves with respect to one another, whereby they mayb'e'moved toward and away from one another through the engagement ofsaid threads, and means driven: by said first sleeve for engaging thespine of a patient to exert pressure thereon when the flange is attachedto the pelvic bone and said sleeves are rotated with respect to oneanother.

2. A device for treating scoliosis comprising a forked member whichexerts pressure against the vertebra at an angle through a screwinserted into the vertebra, a first References Cited in the file of thispatent UNITED STATES PATENTS Megill June 10, 1879 Sloan May 8, 1928

